Oral glucose tolerance test: a reliable tool for early detection of glucose abnormalities in patients with acute myocardial infarction in clinical practice: a report on repeated oral glucose tolerance tests from the GAMI study.
Level 3 - non-randomized controlled study
Prospective observational follow-up study
PubMed 17909086 · doi:10.2337/dc07-1552
What was done
A glucometabolic classification based on an oral glucose tolerance test (OGTT) using capillary whole-blood glucose was evaluated in 122 patients with acute myocardial infarction at three time points: before hospital discharge, at 3 months, and at 12 months post-discharge.
What was found
At discharge, 34% of patients had normal glucose tolerance, 31% had impaired glucose tolerance (IGT), and 34% had type 2 diabetes. After 12 months, 93% of all patients originally classified with type 2 diabetes were still classified with either type 2 diabetes (n = 27) or IGT (n = 12). Agreement between the discharge OGTT and subsequent tests was kappa = 0.35 (P < 0.001) at 3 months and kappa = 0.43 (P < 0.001) at 12 months.
Why it matters
An OGTT performed before hospital discharge after acute myocardial infarction reliably identifies persistent glucometabolic abnormalities over the subsequent year.
Limits
The sample size was modest (122 patients), capillary whole blood was used instead of standard venous plasma glucose, and overall category agreement over time was only fair to moderate (kappa 0.35 to 0.43). Clinical outcomes were not assessed in the abstract.
Cited by
- supports A study of emergency room patients presenting with heart attacks showed that two-thirds had diabetes or pre-diabetes upon glucose tolerance testing.